“It’s a shame that we have to live, but it’s a tragedy that we get to live only one life.”
~Jonathan Safran Foer
If you haven’t heard through some means, my time spent in the Marshall Islands has been cut short. I am currently writing this somewhere over the Pacific Ocean between Majuro and Honolulu. My heart is torn. My emotions have been all over the place in the last 96 hours.
There has been a recent dengue fever outbreak in the Marshall Islands. Dengue fever is a disease spread through mosquitos. Once a mosquito bites an infected person, they carry that virus on to the next host. The virus is also spread to the infected mosquito’s offspring. Dengue fever is endemic to some areas, such as Taiwan, Malaysia, and the Philippines. In these countries, the government and health organizations are always prepared to deal with a dengue outbreak. Typically, experts will spray bushes and quickly try to eliminate breeding grounds of the infected mosquitos. A fast response can really help to reduce the spread of the disease.
The dengue virus has four strains, differing in severity. The least sever strain may clear up in a week despite that there are no vaccines or medications to treat anything aside from the symptoms. The more severe strains have devastating effects. Dengue hemorrhagic fever, a more severe strain, is very painful and can include bleeding from the eyes, ears, and mouth. Death is a possibility at this stage. In addition to the threat of the more severe strains, when an individual has previously had the less severe strain, the more severe strains are even more life threatening.
The dengue fever epidemic in the Marshall Islands is a new occurrence for the country. This is the first time that the country has had an outbreak of dengue. They are experiencing difficulties with getting the situation under control. Because they were not prepared for such an outbreak, as countries where the disease is endemic would be, they could not take immediate action to control the situation. Soon after the dengue cases began to appear, the country ran out of dengue fever test kits. More were shipped to the country right away, but it was only 900 more. When the outbreak began, there were no experts in the country. The CDC has since sent in three experts, and the WHO has sent in one. Though cases began to appear around October 25th, attempting to eliminate mosquito breeding grounds and spraying of mosquito-infested areas is just starting to begin.
This disease is a prefect storm for the Marshall Islands. The country has never had this happen before. This species of mosquito likes to live in places near seas-level, around artificial water containers (which are in extreme abundance in the Marshall Islands because they collect rain water) and the like to live in places of dense population. The country also could suffer because there is only one hospital, which is small and understaffed. Blood transfusions are often necessary in hemorrhagic cases, and the Marshall Islands does not have a blood bank, so first a donor must be found and then the blood must be tested for 48 hours before a transfusion can happen. The geography of the Marshall Islands could also cause trouble. With only one plane running for Air Marshall Islands, it could be difficult for an infected individual to get the medical treatment they need on the main island. On top of that, the locals do not seem to see the severity of the situation and, rather than trying to protect themselves from mosquitos with bug spray and mosquito coils, they go about their daily life. And once bitten by an infected bug, the host does not show symptoms for about one week, so the disease could spread in that time if another uninfected mosquito bites the host.
These conditions make the dengue fever outbreak a very serious situation. It is the reason that I have left the country. WorldTeach has not made evacuation mandatory at this time, but they have given the volunteers the option, and most of the Majuro volunteers (Majuro has about 250 cases) are leaving. Two other volunteers are on the plane with me now, and one will leave once she is released from the hospital. Monica, who taught with me at NVTI has been in the hospital for more than one week. She has dengue fever and is in a lot of pain. I have been told that she does not have hemorrhagic, but I know that she has been bleeding from the gums. The last I had heard from her is that she is moving into the critical state, but that she is hoping to be released on Friday this week.
WorldTeach has been very cautious with their volunteers after the devastating loss of a Marshall Islands volunteer last year in a boating accident.
It was a very difficult decision (perhaps the most difficult decision I’ve ever had to make), and I am not sure if it will ever sit completely well with me. I made the decision after speaking with my family and talking with Monica. It seemed like the wise choice, though it may not have been the choice I wanted to make.
Saying goodbye to my students was very difficult. Hearing pleas of “Sam, don’t go” from Jonitha made it that much harder. I will truly miss all of my students and I wish that I could have spent more time with them. Perhaps some day I will be able to return to finish out my duty, and if I cannot do so in the RMI, I will make up for it elsewhere. I committed to a year of service, and I will have to complete the rest in some other form.
There are many things that I will miss about the Marshall Islands… and sadly I did not realize it until I was saying goodbye. It’s strange how once you begin to walk away you see how great it was. The struggles that I went through were indeed all worth it for the love I felt from my students as I left them today. I often did not feel like my students cared about my class or really enjoyed me as a teacher, but that was certainly not the case. Though I was sad to leave them, I was happy to see that I made them happy. I know that many did not learn a lot during the 3 months I spent as their teacher, but they made it clear to me that I made some kind of difference in their life, and that sits well with me. I could only imagine how they would feel after a full school year as my students. I hope that the students take me up on my offer and write me letters and stay in touch. I do want them to know that I care about them and wish nothing but the best for all of them in life.
As for the volunteers that I am leaving behind, I hope that the remainder of the school year goes well. Keep your heads up and push through because when you say goodbye you will know it was worth the struggles. I hope that you all can stay healthy and that you do not even have to consider leaving early. Have safe travels wherever you may go next. And be wise during mid-service… really.